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NURSING NR326 Mental Health Final Exam Review(Latest 2020)

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Final Exam Review Extrapyramidal Symptoms: involuntary movements 1st Generation Antipsychotics Complications: ● Akinesia: ○ Inability to sit or stand still ○ Continual pacing and agitation ... ● Parkinsonism: ○ Rigidity ○ Tremors ○ Shuffling gait ○ Drooling ○ Bradykinesia ■ Slow movements ● Dystonia: ○ Severe spasms of tongue, neck, face, and back ○ Crisis situation ● Tardive Dyskinesia (Late EPSs) ○ Involuntary movements of the tongue and face ■ Arms, legs, and trunk as well ● Manage with: Think ABCs ○ Trihexyphenidyl: Artane ○ Diphenhydramine: Benadryl ○ Benztropine: Cogentin Children/adolescents ○ Conduct disorder ■ Demonstrate a persistent pattern of behavior that violates the rights of others or rules and norms of society ■ Categories ● Aggression toward animals or people ● Destruction of property ● Deceitfulness or theft ● Serious violations of rules ■ Childhood onset develops before the age of 10 ● More prevalent in males ■ Contributing factors ● Parental rejection or neglect ● Difficult infant temperament ● Physical or sexual abuse ● Lack of supervision ● Early institutionalization ● Large family size ● Association with delinquent peer groups ● Parental history of psychological issues ■ Manifestations ● Lack of remorse or care for the feelings of others ● Bullies, threatens, or intimidates others ● Believes aggression is justified ● Exhibits low self-esteem ● Temperamental outbursts ● May demonstrate suicidal ideation ● Concurrent learning disorders ● Destroys property of others ● Often lies and/or shoplifts ○ Autism ■ Neurodevelopmental disorder thought to be of genetic origin with behaviors that affect an individual's ability to communicate and interact with others. ■ Cognitive and language development are typically delayed ■ More common in boys than girls ■ Can range from poor to high functioning ability ■ Nursing interventions ● Provide structured environment ● Encourage parents to participate in child’s care ● Use short and concise communication ● Reward for good behavior ● Role-model social skills ● Limit self-stimulating and ritualistic behaviors ● Determine emotional and situational triggers ● Ensure safety and monitor behavior for risks ■ Typically SSRI and antipsychotic meds are given such as Risperidone or Olanzapine ■ Characteristics ● Sensory integration dysfunction ● Sleep disorders ● Digestive disorders ● Feeding disorders ● Epilepsy ● Ritualistic or repetitive behavior ● Children Medication: ○ Ritalin (methylphenidate) p.146 ○ Used in ADHD ○ CNS stimulant ○ Administer last dose before 4pm or patient will not be able to sleep ○ Do not take caffeine/tea/cola/chocolate (will enhance effect) ○ Can be used for adults and children ○ Side effects: ■ Palpitations or dysrhythmias ■ Increase blood pressure ■ Weight gain ■ Monitor vitals ■ Insomnia or restlessness ○ Contraindications: ■ Pregnancy ■ Cardiovascular disorders ■ Substance abuse ○ Administration: ■ Oral 30-40 min before meals ■ Not after 4pm, keep them awake ■ No alcohol usage ■ Monitor vital signs and ECG ■ May take 6 weeks to see full effect ○ Tolerance: ■ can cause substance use disorders ■ Should not be stopped abruptly ● Can cause depression and severe fatigue ○ Patch: ■ Apply to hip in the morning ■ leave no longer than 9 hours [Show More]

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